Association of Serum Levels of Ghrelin and NLRP3 with Diabetic Retinopathy

To investigate the serum levels of ghrelin and Nod-like receptor protein 3 (NLRP3) in patients with diabetic retinopathy (DR) and evaluate their correlation with DR progression.

Thirty-seven patients with DR admitted to the First People's Hospital of Xianyang between April 2024 and April 2025 were enrolled and classified into non-proliferative DR (NPDR) and proliferative DR (PDR) subgroups based on fundus lesion severity. Fifty-three patients with simple cataracts served as controls. Serum levels of ghrelin and NLRP3 were measured using enzyme-linked immunosorbent assay, and their relationship with systemic indicators was analyzed.

Serum ghrelin and NLRP3 levels differed significantly between the PDR, NPDR, and control groups (p < 0.001). Pairwise comparisons revealed statistically significant differences in serum ghrelin levels between the PDR and control groups, as well as between the NPDR and control groups (both p < 0.017). Serum NLRP3 levels differed significantly between the PDR and control, the PDR and NPDR, and the NPDR and control groups (all p < 0.017). Serum ghrelin levels were positively correlated with high-density lipoprotein levels (r = 0.325, p < 0.05) and the use of statin lipid-lowering drugs (r_s = -0.397, p < 0.05).

Decreased serum ghrelin and elevated serum NLRP3 levels in patients with DR suggest that ghrelin and NLRP3 are involved in DR pathogenesis.